IDDM is a risk factor for adolescent psychiatric disorders

OBJECTIVE: To determine whether the rate of psychiatric disorders increases in children and adolescents with IDDM. RESEARCH DESIGN AND METHODS: The rate of psychiatric disorders was assessed by highly structured interviews in a group of 93 IDDM adolescents 17-19 yr of age and compared with a healthy (nondiabetic) age-, sex-, and socioeconomic status-matched control group. RESULTS: The rate of psychiatric disorders was 33.3% in the diabetic group, more than threefold higher than in the control group (9.7%). With regard to the rate of psychiatric disorders, no sex-specific differences between the two groups were found. The diabetic adolescents suffered from significantly more introversive symptoms than their healthy counterparts, especially somatic symptoms, sleeping disturbances, compulsions, and depressive moods. In spite of the elevated rate of psychiatric disorders, the rates of life events and familial adversities did not increase in the diabetic group. CONCLUSIONS: The results support the notion that IDDM adolescents should be seen as a high-risk group for psychiatric disorders.     

Parental 'affectionless control' as an antecedent to adult depression: a risk factor refined

It has been well established that individuals with a history of depression report their parents as being less caring and more overprotective of them than do controls. 'Affectionless control' in childhood has thus been proposed as a risk factor for depression. Evidence is presented from a logistic regression analysis of data from a volunteer community sample that lack of care rather than over-protection is the primary risk factor. No evidence for an interaction effect of low care and over-protection was found.     

Sleep disorders presenting as psychiatric disorders

In summary, disordered sleep can present in a complex and atypical fashion in which the primary sleep-related component may not be immediately apparent. A high index of suspicion serves the clinician well in these cases. A careful and systematic evaluation of sleep often proves to be rewarding in terms of diagnostic accuracy and improved treatment outcome.     

Bufotenine reconsidered as a diagnostic indicator of psychiatric disorders

We have analyzed products of the serotonin-degradative pathway, in which both N-methylserotonin and bufotenine are formed in urine specimens of products with psychiatric disorders by three-dimensional HPLC with electrochemical detection. Bufotenine was detected in urine from all autistic patients with mental retardation and epilepsy (n = 18) and many autistic patients (32/47) with mental retardation. Bufotenine was detected in the urine of 15 of 18 patients with depression. Thirteen of 15 schizophrenic patients were also positive for bufotenine. N-methylserotonin was also detected in some cases of each disorder. Only two of 200 urine specimens from healthy controls were positive for bufotenine. Thus, the presence and levels of bufotenine might be useful and important markers of some psychiatric disorders.     

Professional work of woman as a risk factor for circulation disorders

The author presents an up-dated review of the literature on the effects of professional work on the incidence of diseases of the circulatory system in women, and the incidence of ischaemic heart disease and arterial hypertension in particular. An analysis of health effects of professional work revealed that a limited influence on the final effect of own work (a limited control of own situation at work) and subordination to superiors, belong to these factors which exert the most detrimental effect on the circulatory system. A negative effect frequently manifested by the level of blood pressure is also related with heavy physical burden. The literature data also reveal that the professional work, itself, does not contribute to an increased incidence of diseases of the circulatory system or to the profile of risk factors. A possible reason for this observation lies in similar responsibilities faced by women acting only as housewives and those faced in occupational work. The review presented also stresses the role of endogenic risk factors in women related with the number of pregnancies/deliveries as well as with menopause.     

Adding a dimension: Time as a factor in the generalizability of predictive relationships.

Trends in predictive validity coefficients across time or repeated performance assessments show significant trends. Commonly used predictors show decreasing validities for the prediction of temporally more remote performance assessments. Within-study corrections for statistical artifacts across performance assessments increased the negative slopes of the regressions of predictive validities on ordinal position of performance assessment. The average corrected validity decrement from initial to final performance assessment was –.60; the trimmed average decrement was –.45; the median decrement was –.29. The average within-study correlation between predictive validity and time of performance assessment was –.80. An analysis of stability coefficients of Time Period?×?Time Period performance assessments revealed similar findings. Several theoretical explanations are discussed as reasons for predictive validity decrements. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Molecular modulation of prefrontal cortex: Rational development of treatments for psychiatric disorders.

Dysfunction of the prefrontal cortex (PFC) is a central feature of many psychiatric disorders, such as attention deficit hyperactivity disorder (ADHD), posttraumatic stress disorder (PTSD), schizophrenia, and bipolar disorder. Thus, understanding molecular influences on PFC function through basic research in animals is essential to rational drug development. In this review, we discuss the molecular signaling events initiated by norepinephrine and dopamine that strengthen working memory function mediated by the dorsolateral PFC under optimal conditions, and weaken working memory function during uncontrollable stress. We also discuss how these intracellular mechanisms can be compromised in psychiatric disorders, and how novel treatments based on these findings may restore a molecular environment conducive to PFC regulation of behavior, thought and emotion. Examples of successful translation from animals to humans include guanfacine for the treatment of ADHD and related PFC disorders, and prazosin for the treatment of PTSD. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Parental antecedents of adult codependency

Two aspects of codependency were investigated among 442 undergraduates. First, parental antecedents were examined by subjects completing measures of codependency, perceived parental dysfunctions (compulsivity, chemical dependency, and codependency), and parental styles (coercion, control, and non-nurturance). As expected, correlations between adult codependency and parental coercion, control, non-nurturance, and maternal compulsivity were significant. However, correlations between codependency and parental chemical dependency were not significant. A multiple regression analysis identified parental codependency and maternal coercion as significant predictors of subject codependency. To examine the second aspect of codependency, which assumes that codependency was identified over 40 years ago by Karen Horney, subjects completed a loss of self measure which correlated highly with codependency.     

Parental drinking as a risk factor for children's maladjustment: The mediating role of family environment.

In the present study, the relationships among parental drinking, family environment, and child adjustment is investigated in a community sample of 207 10-14-year-olds. Multiple aspects of perceived family environment (e.g., cohesion, organization, conflict) as well as multiple indicators of adjustment (e.g., negative affect, feelings of competence, self-esteem) are taken into consideration. Parental alcohol problems are found to be associated with low family cohesion, poor family organization, and low global self-worth of the child. A mediational analysis reveals that the relation between parental drinking and low global self-worth is mediated by family cohesion. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social anhedonia as a predictor of the development of schizophrenia-spectrum disorders.

College undergraduates (n?=?34) identified by deviant scores (at least 1.96 SD above the mean) on the Revised Social Anhedonia (SocAnh) Scale (M. Eckblad, L. J. Chapman, J. P. Chapman, & M. Mishlove, 1982) were compared with control participants (n?=?139) at an initial assessment and at a 10-year follow-up evaluation. Twenty-four percent of the SocAnh group were diagnosed with schizophrenia-spectrum disorders at the follow-up compared with only 1% of the control group, despite the fact that there had been no such difference between the groups at the initial assessment 10 years earlier. The SocAnh group exceeded the control group on severity of psychotic-like experiences and had poorer overall adjustment at the follow-up but not at the initial assessment. The groups did not differ on mood symptoms or substance-use disorders. Thus. the SocAnh Scale, unlike the Perceptual Aberration and Magical Ideation Scales, appears to identify individuals at specific risk for future development of schizophrenia-spectrum disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prevalence of minor psychiatric disorders in an adult African rural community in South Africa

BACKGROUND: This paper reports on a two-stage community-based epidemiological study of selected minor psychiatric disorders conducted on an adult African population in South Africa. METHODS: Using a modified random cluster sampling method, 354 adults were identified as the first-stage sample, with the SRQ-20 being used as a first-stage screen. Clinical interviews based on DSM-IV checklists for generalized anxiety disorder, major depression and dysthymia were administered as the second-stage criterion to 81 subjects from the sample. RESULTS: The weighted prevalence for generalised anxiety and depressive disorders was 23.9% (95% CI 15.1%-32.7%), comprising: generalized anxiety 3.7%, major depression 4.8%, dysthymia 7.3%, and major depression and dysthymia 8.2%. Statistically significant associations were found between caseness and age, marital status, employment, income and educational level. CONCLUSIONS: The results are discussed in relation to comparative local and international data as well as in the context of the current restructuring of the mental-health care system in South Africa from tertiary curative care to integrated primary mental-health care.     

Marriage as a risk factor for internalizing disorders: Clarifying scope and specificity.

Objective: Marital discord has been linked to both depression and anxiety; however, our understanding of how marriage contributes to the development of internalizing symptoms is limited in scope and lacking specificity. First, it is unclear whether the marital relationship contributes to the broad dimension of internalizing symptoms as opposed to specific diagnoses. Second, it is unclear how the marital relationship contributes to internalizing symptoms: through global marital dissatisfaction or through specific relationship processes (and which processes). The purpose of the present study was to address these 2 issues and, more generally, to develop a comprehensive and refined framework within which to understand the role of marriage in the developmental course of internalizing symptoms. Method: Questionnaire and interview data were collected from 102 husbands and wives 5 times over the first 7 years of marriage. Results: Results indicated that marital discord during the transition into marriage was associated with the broad dimension of internalizing symptoms for husbands but not for wives. Further, both global marital dissatisfaction and an imbalance of power and control put husbands at significant risk for symptoms over the first 7 years of marriage, whereas low levels of emotional intimacy put wives at significant risk. Conclusions: Results exemplify the need to routinely consider intimate relationship processes in etiological models of depression and anxiety and to identify specific clinical targets that can be prioritized in interventions aimed at preventing internalizing disorders. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

A quarterway house for adult psychiatric patients

An intermediate step between living on a hospital ward and living in the community was considered necessary for many acute and chronic patients preparing to leave Harlem Valley Psychiatric Center in New York. A quarterway house program was initiated to help patients acquire the skills and coping mechanisms they could not easily acquire on a ward setting, but which they would need to meet the demands of living in the community. The quarterway house program described may offer ideas to others who are attempting to help patients prepare for living outside a state hospital.     

Linkage studies of psychiatric disorders

Linkage analysis has been successful in identifying the genetic basis of numerous Mendelian diseases. These successes were due in part to the rapid developments in molecular biology, which have yielded a plethora of informative genetic markers. Although there is strong evidence that the manifestation of schizophrenia and bipolar affective disorders is controlled by genes, no evidence for linkage has been established. For psychiatric disorders, the most important limiting factor is likely to be the lack of single loci with very large effects that occur with any relevant frequency. The difficulties of linkage studies in psychiatric disorders are discussed with reference to non-psychiatric genetic diseases for which linkage to genetic markers has been successful. Recommendations for collecting information to clarify the patterns of transmission of the psychiatric disorders are described.     

Human herpesvirus 6 infection as a risk factor for the development of severe drug-induced hypersensitivity syndrome

OBJECTIVES: To test suitability of radiographic evaluation of lung lesions as a substitute for lung lesion scores derived by examination at necropsy in challenge-exposure models of bovine pneumonia. ANIMALS: 10 calves selected by body weight from 20 multiple-source male Holstein calves approximately 1 to 2 months old enrolled in a Pasteurella multocida challenge-exposure study. PROCEDURE: Calves were paired on the basis of weight and randomly assigned within pairs to vaccine or control (saline solution) group. By use of deep tracheal cannulation, calves were challenge exposed with a culture of virulent P multocida, observed for 10 days, euthanatized, and necropsied, and the lungs were scored for pneumonic lesions. Radiographic views of the lung fields of the calves were taken before challenge exposure and before necropsy and were evaluated for alveolar disease by a veterinary radiologist. Lung lesion scores were compared with radiographic evaluations. RESULTS: There was a strong and significant correlation (R2 = 0.91, P < 0.001) between results of the evaluation of postchallenge-exposure radiographs and necropsy results. There also was also strong and significant correlation (R2 = 0.90, P < 0.001) between evaluation of the prechallenge-exposure radiographs and necropsy results. CONCLUSIONS: Radiographic evaluation of lung lesions correlates well with lung lesions found at necropsy. The findings emphasize the need for caution in interpreting the results of challenge-exposure studies of bovine respiratory tract disease in which small numbers of calves are studied.     

Fundamental neuroscience and the classification of psychiatric disorders

Non-Darwinian views of evolution of nervous systems (e.g., Jacksonian evolution) conceive the present structure of the human brain as composed of a series of additive layers representing successive phylogenetic stages in evolution, layers which remain static after their emergence. In contrast to this view, recent allometric studies clearly show that limbic structures scale with the growth of the human brain (i.e., they do not remain stable but reach the size expected for the brain of a primate with the weight of a human brain). Data also show that limbic structures are significantly involved in cognitive functions such as memory and attention. Hence overlap of lesions in similar brain loci, especially in limbic regions, in both manic-depression and schizophrenia should come as no surprise. In the psychobiological sphere, the need for cognitive perceptual evaluation of the external world and internal state for emotional experience, further to the necessary visceral arousal, leads to a breakdown of the platonic, essentialist position, emotion vs. cognition at the psychological level, a problematic issue for the Kraepelinean view. Neural networks operation depend upon multiple nonlinear processes at the cellular, synaptic and network levels. Afferent input may serve not only to activate, but also to configure them into one of several circuit modes. These networks have been named polymorphic and can, at least to a measure, account for commonalities in lesion sites, in both affective and schizophrenic diseases. It is proposed that fundamental neuroscience should serve as one of the bases for the classification of psychiatric disorders.     

The interleukin-1 genotype as a severity factor in adult periodontal disease

OBJECTIVE: To determine whether it is possible to predict the presence of bladder outlet obstruction (BOO) by non-invasive clinical variables in patients with lower urinary tract symptoms (LUTS) suggestive of BOO. PATIENTS AND METHODS: Patients with LUTS suggestive of BOO were entered into a prospective protocol evaluating the International Prostate Symptom Score (IPSS), prostate size, non-invasive uroflow, post-void residual urine volume (PVR) and a pressure flow study. Only patients with a maximum flow rate (Qmax) of < or = 15 mL/s and an IPSS > or = 7 were included. The study comprised 253 patients; the degree of obstruction was correlated to several non-invasive clinical variables. Subsequently nomograms were developed by multiple logistic regression analysis to obtain the probability of BOO in patients with LUTS. RESULTS: Prostate volume, Qmax, PVR and voided volume correlated significantly with the degree of BOO rated according to the linear passive urethral resistance relation (linPURR). In contrast, there was no such correlation for the IPSS and the quality-of-life question of the IPSS. The percentage of patients with BOO defined by a linPURR of 3-6 decreased from 85% in those with a Qmax of 0-5 mL/s to 60% (Qmax 6-10 mL/s) and 44% (Qmax 11-15 mL/s). In parallel, the percentage of patients with BOO increased from 53% of those with a prostate volume of < or = 50 mL, to 79% of those with prostates of 51-100 mL and 75% of those > 100 mL. Based on Qmax, PVR and prostate volume, nomograms were established by multiple logistic regression analysis for the probability of BOO in patients with LUTS. CONCLUSION: The nomograms presented herein should help the clinician to identify patients with LUTS who should undergo pressure flow studies before surgical intervention to detect the presence of obstruction and in whom these studies can be safely spared.